Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 0 0 2026 06 16 1616 1616 Kimia Khonakdar Department of Anesthesiology, Allied Medical School, Master of Science in Anesthesia Education, Mazandaran University of Medical Sciences, Sari, Iran. Maliheh Shirzad Department of Operating Room, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran Raha Bakhtiari Department of Anesthesiology, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran. Arian Jahromi Department of Anesthesiology, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran. Talieh Rostamian Department of Anesthesiology, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran. 2026 04 16 2026 05 04 Background: Patients undergoing neuraxial anesthesia remain conscious during surgery and may experience perioperative anxiety and psychological distress. Virtual reality (VR) has been proposed as a non-pharmacological strategy to improve patient experience. This scoping review aims to map current evidence on VR effects on psychological and experiential outcomes in adults undergoing neuraxial anesthesia. Methods: This scoping review was conducted in accordance with PRISMA-ScR guidelines. PubMed, Scopus, Web of Science, and Embase were searched up to November 2025. Studies investigating the use of virtual reality among adult patients receiving neuraxial anesthesia in the operating room were included. Information regarding study design, characteristics of the VR intervention, and reported outcomes was collected and summarized narratively. Results: 13 studies involving 1,127 participants were identified, including 12 randomized controlled trials and one matched retrospective cohort study. Most interventions employed immersive VR during the intraoperative period. Anxiety and stress were the outcomes most frequently assessed, and a large proportion of studies reported significant reductions in anxiety following VR use. Evidence regarding pain reduction was variable and showed limited and inconsistent benefits across studies. Patient satisfaction and comfort were generally improved, whereas findings related to sedative requirements were mixed, with several studies reporting reduced sedative use. Conclusion: VR appears to be a useful adjunct for enhancing perioperative patient experiences, especially with respect to anxiety reduction and patient satisfaction in adults undergoing neuraxial anesthesia. However, evidence concerning pain outcomes and medication use remains inconclusive, emphasizing the importance of conducting well-designed studies with standardized outcome measures. https://aacc.tums.ac.ir/index.php/aacc/article/view/1616